X线下肾结石成分判断及体外冲击波碎石疗效预测

Determination of the composition of kidney stones and prediction of the efficacy of extracorporeal shock-wave lithotripsy by X-rays

目的探讨通过X线下观察肾结石的形态及密度判断结石成分及预测ESWL疗效的临床价值。方法2010年3月至2011年6月收治肾结石患者358例，男204例，女154例。年龄17—58岁，平均39岁。单发结石276例，其中左肾124例，右肾152例；结石位于肾上盏38例、中盏82例、下盏156例。多发结石82例，双肾多发18例，单肾多发54例，其中左肾23例，右肾31例；结石位于上盏7例、中下盏75例。结石直径6—18mm。分析患者术前X线片中结石形态、密度及透视下动态情况，初步判断结石成分，预测ESWL疗效，制定治疗方案。采用红外光结石成分自动分析仪分析结石成分，验正术前判断结果的准确性。结果358例患者治疗后获取结石339例，术前X线下判断的肾结石成分与术后红外光结石成分自动分析结果基本相符308例（86．O％），其中二水磷酸氢钙2例，符合2例（100．0％）；一水草酸钙14例，符合11例（78．6％）；一、二水草酸钙54例，符合45例（83．3％）；碳酸磷灰石或草酸钙与碳酸磷灰石混合256例，符合229例（85．9％）；六水磷酸镁铵与碳酸磷灰石26例，符合17例（65．4％）；尿酸6例，符合4例（66．7％）。339例（94．7％）ESWL效果与术前预测结果一致。结论通过X线判断结石成分，预测ESWL疗效具有可行性。

Objective To evaluate the clinical value of determination of composition of kidney stones by shap and density and of prediction of the efficacy of extracorporeal shock-wave lithotripsy （ESWL） by X-rays. Methods The data of 358 patients were analyzed, with 204 male and 154 female and with 276 cases of solitary stones and 82 eases of multiple stones. Determine the composition of kidney stones by shap and density, predict the efficacy of ESWL by X-rays, and ehoose the appropriate method of treatment. Ana- lyze stone chemical property by Infrared stone composition automatic analyzer to checkout the prediction re- sults before surgeries. Results 339 eases were sueeessful to remove stones after treatment. The prediction results of 308 eases （86.0%） were consistent in stone chemical property, and the preperative prediction resuits of 339 cases （94.70/0） were consistent in ESWL efficacy. Conclusions Determination of composition of kidney stones and prediction of the efficacy of ESWL by X-rays were feasible.